Alternate Job Preferences

Alternate Job Preference #1:

Alternate Job Preference #2:

Registration Waiver

PLEASE READ AND SIGN MANDATORY RELEASE BELOW
I understand that running or walking in the Heaven Can Wait event is a potentially hazardous activity. I attest that I am physically fit, have sufficiently trained for participation in this event, and have not been advised against participation by a qualified health professional. In consideration of accepting my application, I, for myself and anyone entitled to act on my behalf, waive, release, and discharge from any and all claims or liabilities of any kind which arise out of or relate to my participation in this event, and I indemnify and hold harmless any and all sponsors including but not limited to St. Charles Health System, the organizers and representatives, officers, agents, and successors from all claims or liabilities of any kind made, waived, released, or discharged herein, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I understand that my name and or photo may be used for promotional purposes.

*I fully understand and accept all conditions in this waiver.

Please Sign Below

Your electronic signature is the online equivalent of your ink-on-paper signature,
and can be provided by typing your name where indicated.
The electronic signature will signify your understanding, acceptance, and authorization
to accept the conditions of this legal document, including the following statements:

I have read, have understood, and do accept the agreement above.

I understand that this is a legal document with effects that I approve and authorize.

The registrant is the person(s) whose name is submitted as the recipient of the goods and services provided as a result of this transaction.

I am authorized to agree to the terms of this document on behalf of the registrant.

If the registrant is under 18 years of age, incapacitated, or mentally challenged, I assert that I am the parent/legal guardian or otherwise authorized to execute a legally binding agreement on behalf of the registrant.